ATI Exam 4 practice exam
1. A charge nurse is discussing disaster response with nursing staff. Which of the following
statements indicates an understanding of the Hospital Incident Command System (HICS)?
a. HICS identifies facility responsibilities and channels of reporting.
i. HICS identifies responsibilities and channels of reporting within the facility to
provide a uniform response plan among facilities.
2. A nurse is setÝng goals for a client who has AIDS and is at the end of life. Which of the following
are realistic goals?
a. The client will receive medication to minimize episodes of breakthrough pain.
i. The client should receive medication to minimize episodes of breakthrough
pain as a goal for the end of life care.
3. A nurse is admitting a client who is about to undergo surgery for benign prostatic
hypertrophy. The client states, “I don’t know what I will do if they find I have cancer.”
Which of the following responses should the nurse make?
a. “I’m hearing that you are concerned that it might turn out that you have cancer.”
i. This response illustrates the therapeutic communication techniques of
seeking clarification and restating. It demonstrates the nurse's willingness to
explore the client's fears and encourages communication.
4. A female middle adult client tells a nurse that she tested positive for a mutant BRCA1
gene. The nurse should recognize that the client is at an increased risk for which of the
following situations?
a. Developing breast cancer.
i. The BRCA1 gene is used to determine the probability of a client developing
breast cancer. BRCA1 genetic testing is used for women who have a strong
family history of breast cancer.
5. A nurse is caring for a client who reports a new onset of severe chest pain. Which of the
following actions should the nurse take to determine if the client is experiencing a
myocardial infarction?
a. Perform a 12-lead ECG
i. The nurse should perform a 12-lead ECG when a client complains of chest
pain to determine if the client is experiencing a myocardial infarction.
6. A nurse witnesses a motor vehicle crash and finds a client who is not breathing. The nurse
suspects the client has a cervical vertebrae fracture. Which of the following actions should
the nurse take first?
a. Place the client in a rigid cervical collar.
b. Open the client’s airway using the jaw-thrust maneuver.
i. When using the airway, breathing, circulation approach to client care, the
nurse determines that the priority action is opening the client’s airway using
the jaw-thrust maneuver to protect the client’s cervical spine. The priorities
of care at an accident scene, and when using the ABC approach to client
care, are airway, breathing, and circulation
c. Evaluate the client for other injuries.
d. Complete a neurological check on the client.
, 7. A nurse is participating in a disaster simulation in which a toxic substance is released into a
crowded stadium. Multiple clients are transported to the facility. Which of the following activities
would be the lowest priority for the nurse?
a. Preventing cross-contamination of clients
b. Performing concise client assessment
i. In the triage setting, the nurse provides essential care; therefore, the nurse
must conduct concise client assessments for triage purposes.
c. Transferring a client to the discharge location
i. Nursing care in a disaster setting focuses on essential care. The nurse should
recognize nonskilled interventions, such as transferring a client to the
discharge location, can be performed by nonmedical personnel.
d. Maintaining a client tracking system
8. A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an
opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication
might hasten the client’s death. Which of the following ethical principles should the nurse use to
support the decision not to administer the medication?
a. Utilitarianism
i. Utilitarianism refers to actions that are right when they contribute to the
greatest good.
b. Nonmaleficence
i. Nonmaleficence is the duty to do no harm. The ethical mandate of
nonmaleficence is that health care workers refrain from intentionally inflicting
harm to clients.
c. Fidelity
i. Fidelity is the duty to keep one's promises or word. It refers to the obligation
to be faithful to the agreements, commitments, and responsibilities that one
has made to oneself and others.
d. Veracity
i. Veracity is the duty to tell the truth. It means that one does not intentionally
deceive or mislead clients.
9. A nurse in the emergency department is caring for a client who was sexually assaulted.
Which of the following resources will provide the most effective support immediately
following the incident?
a. Psychologist
i. Referral to a psychologist is not usually done immediately following the
incident. The professional consult is part of long-term treatment because
many individuals who have been sexually assaulted are likely to benefit from
individual or group therapy or support groups. Many individuals who are
sexually assaulted experience long-term emotional trauma that can manifest
itself in a variety of ways, including depression, anxiety, and fear.
b. Close friend
i. Sexual assault survivors who confide in a family member or friend
immediately after the incident are more likely to develop fewer somatic
manifestations of stress.
c. Social worker
1. A charge nurse is discussing disaster response with nursing staff. Which of the following
statements indicates an understanding of the Hospital Incident Command System (HICS)?
a. HICS identifies facility responsibilities and channels of reporting.
i. HICS identifies responsibilities and channels of reporting within the facility to
provide a uniform response plan among facilities.
2. A nurse is setÝng goals for a client who has AIDS and is at the end of life. Which of the following
are realistic goals?
a. The client will receive medication to minimize episodes of breakthrough pain.
i. The client should receive medication to minimize episodes of breakthrough
pain as a goal for the end of life care.
3. A nurse is admitting a client who is about to undergo surgery for benign prostatic
hypertrophy. The client states, “I don’t know what I will do if they find I have cancer.”
Which of the following responses should the nurse make?
a. “I’m hearing that you are concerned that it might turn out that you have cancer.”
i. This response illustrates the therapeutic communication techniques of
seeking clarification and restating. It demonstrates the nurse's willingness to
explore the client's fears and encourages communication.
4. A female middle adult client tells a nurse that she tested positive for a mutant BRCA1
gene. The nurse should recognize that the client is at an increased risk for which of the
following situations?
a. Developing breast cancer.
i. The BRCA1 gene is used to determine the probability of a client developing
breast cancer. BRCA1 genetic testing is used for women who have a strong
family history of breast cancer.
5. A nurse is caring for a client who reports a new onset of severe chest pain. Which of the
following actions should the nurse take to determine if the client is experiencing a
myocardial infarction?
a. Perform a 12-lead ECG
i. The nurse should perform a 12-lead ECG when a client complains of chest
pain to determine if the client is experiencing a myocardial infarction.
6. A nurse witnesses a motor vehicle crash and finds a client who is not breathing. The nurse
suspects the client has a cervical vertebrae fracture. Which of the following actions should
the nurse take first?
a. Place the client in a rigid cervical collar.
b. Open the client’s airway using the jaw-thrust maneuver.
i. When using the airway, breathing, circulation approach to client care, the
nurse determines that the priority action is opening the client’s airway using
the jaw-thrust maneuver to protect the client’s cervical spine. The priorities
of care at an accident scene, and when using the ABC approach to client
care, are airway, breathing, and circulation
c. Evaluate the client for other injuries.
d. Complete a neurological check on the client.
, 7. A nurse is participating in a disaster simulation in which a toxic substance is released into a
crowded stadium. Multiple clients are transported to the facility. Which of the following activities
would be the lowest priority for the nurse?
a. Preventing cross-contamination of clients
b. Performing concise client assessment
i. In the triage setting, the nurse provides essential care; therefore, the nurse
must conduct concise client assessments for triage purposes.
c. Transferring a client to the discharge location
i. Nursing care in a disaster setting focuses on essential care. The nurse should
recognize nonskilled interventions, such as transferring a client to the
discharge location, can be performed by nonmedical personnel.
d. Maintaining a client tracking system
8. A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an
opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication
might hasten the client’s death. Which of the following ethical principles should the nurse use to
support the decision not to administer the medication?
a. Utilitarianism
i. Utilitarianism refers to actions that are right when they contribute to the
greatest good.
b. Nonmaleficence
i. Nonmaleficence is the duty to do no harm. The ethical mandate of
nonmaleficence is that health care workers refrain from intentionally inflicting
harm to clients.
c. Fidelity
i. Fidelity is the duty to keep one's promises or word. It refers to the obligation
to be faithful to the agreements, commitments, and responsibilities that one
has made to oneself and others.
d. Veracity
i. Veracity is the duty to tell the truth. It means that one does not intentionally
deceive or mislead clients.
9. A nurse in the emergency department is caring for a client who was sexually assaulted.
Which of the following resources will provide the most effective support immediately
following the incident?
a. Psychologist
i. Referral to a psychologist is not usually done immediately following the
incident. The professional consult is part of long-term treatment because
many individuals who have been sexually assaulted are likely to benefit from
individual or group therapy or support groups. Many individuals who are
sexually assaulted experience long-term emotional trauma that can manifest
itself in a variety of ways, including depression, anxiety, and fear.
b. Close friend
i. Sexual assault survivors who confide in a family member or friend
immediately after the incident are more likely to develop fewer somatic
manifestations of stress.
c. Social worker
